American Journal of Clinical and Experimental Medicine

2019; 7(2): 42-46

http://www.sciencepublishinggroup.com/j/ajcem
doi: 10.11648/j.ajcem.20190702.11
ISSN: 2330-8125 (Print); ISSN: 2330-8133 (Online)

Homeopathy and Pluralism of Theories in Medicine

Arguments Put Forward to Remove Homeopathic Products
from Pharmacies Contradict Actual Scientific Evidence and
Suggest Deliberate Misinformation
Peter Friedemann Matthiessen
Institute of Integrative Medicine (IfIM), Witten/Herdecke University, Witten, Germany

Email address:

To cite this article:

Peter Friedemann Matthiessen. Homeopathy and Pluralism of Theories in Medicine Arguments Put Forward to Remove Homeopathic
Products from Pharmacies Contradict Actual Scientific Evidence and Suggest Deliberate Misinformation. American Journal of Clinical and
Experimental Medicine. Vol. 7, No. 2, 2019, pp. 42-46. doi: 10.11648/j.ajcem.20190702.11

Received: January 5, 2019; Accepted: April 13, 2019; Published: June 26, 2019

Abstract: Founded in 2000 by renowned physicians and researchers on the initiative of Professor Dr. med. Dr. h.c. Jörg-
Dietrich Hoppe, then president of the German Medical Association, the Dialogue Forum Pluralism in Medicine (DPM) aims to
overcome the traditional partisan bias between conventional medicine and complementary medicine by way of continued
critical and objective dialogue between acknowledged representatives of different theoretical and practical approaches, in
favour of an Integrative Medicine. The article describes the initiative in Germany as linking up with the concept of Integrative
Medicine which originated from the United States and today is spreading across the world. The DPM strives to assess
divergent paradigms in medicine for their potential to complement each other. Current DPM members are established
proponents of mainstream medicine, anthroposophical medicine, homeopathy, classical naturopathy and Chinese Medicine
(TCM). It has become fashionable to belittle homeopathy as being ineffective, using inaccurate statements on the state of
research. On behalf of the DPM members as well as numerous medical organisations and renowned physicians and
researchers, this article comments on such unjustified claims by means of specific examples. The idea is to establish Integrative
Medicine in a spirit of critical but unbiased collaboration between mainstream medicine and selected complementary
approaches as a precondition for a fully orchestrated healthcare system that meets the individually varying needs and
preferences of the population. In this context, reference is made to a position paper on medical professionalism signed by all
DPM members which underlined that conventional and complementary medicine alike are obliged to adhere to scientific
standards. Ludwig Fleck and Thomas Kuhn already described tendencies among proponents of specific paradigms to claim
privileges for their own paradigm via legislation. However, under Basic Law (German constitution) Article 5 Paragraph 3, the
state is generally forbidden to pass judgment on scientific matters in the sense of advocacy of one specific paradigm. It should
also be noted that attempts to monopolize a single paradigm favour the emergence of totalitarian thought patterns. In a final
vote, the signatories – established medical organisations and numerous physicians and scientists of renown – reject all efforts
to pursue totalitarian thought patterns in our healthcare system which are irreconcilable with constitutional law.

Keywords: Status of Homeopathy, Therapeutic Efficacy, Placebo Effect, Meta-Analyses, Dispute Between Paradigms,
Co-existence of Paradigms, Evidence-Based Integrative Medicine

Against the background of numerous and unsustainable
general attacks at national and international level on
complementary medicine in general and homeopathy in
particular,
this article presents a plea for evidence-based integrative
medicine as embodied in German Basic Law, drawn up on
behalf of the Dialogue Forum Pluralism in Medicine (DPM)
and other institutions and individuals listed below. There are
two immediate reasons for this position statement: first, the
“Münsteraner Memorandum Homöopathie”, presented at the
recent 121st meeting of the German Medical Association in
Erfurt with the demand to abolish homeopathy as an
43 Peter Friedemann Matthiessen: Homeopathy and Pluralism of Theories in Medicine Arguments Put Forward to Remove Homeopathic
Products from Pharmacies Contradict Actual Scientific Evidence and Suggest Deliberate Misinformation
additional medical specialization [1], and second, a pamphlet
by Edzard Ernst which appeared in the column
“Außenansicht” of Süddeutsche Zeitung on 10 August 2018,
where Ernst requests pharmacists to inform customers that
homeopathic products are “ineffective placebos”, claiming
their therapeutic effect is unproven. On 11 October 2018 the
column “Meinung” of Süddeutsche Zeitung contained a
statement by Werner Bartens which is arbitrary by nature and
in conflict with the actual evidence available. Among other
things Bartens argues that “anything that bears the label of
homeopathy should be removed from pharmacies since no
benefit has ever been reliably demonstrated for these and
many other such remedies …”, and that “this has been
proven a hundred times over”.
While a response to the “Münsteraner Memorandum
Homöopathie” (authors: Münsteraner Kreis) has already been
made [2, 3], the articles by Ernst [4] and Bartens [5] have not
been commented upon so far. Ernst suggested to withdraw
homeopathic products – which he believes to be placebos
without therapeutic effect - from the market by requesting
pharmacists to inform customers accordingly. Unfortunately
the texts drawn up by E. Ernst and W. Bartens are neither
objective nor scientifically substantiated; instead, they
present study findings on the therapeutic efficacy of
homeopathy in a manner that is tendentious and factually
inaccurate. This together with the fact that derogative
remarks on homeopathy have become fashionable recently
[6-12] has induced the members of the Dialogue Forum
Pluralism in Medicine (DPM) as well as the institutions listed
below and the physicians and scientists who have signed this
reply to draw up a corrective statement with reference to
international representative clinical studies, meta-analyses
and HTAs on homeopathy [13-25].
Founded in 2000 by Professor Dr. med. Dr. h.c. Jörg-
Dietrich Hoppe, then president of the German Medical
Association, with the backing of renowned physicians and
researchers, the Dialogue Forum Pluralism in Medicine
(DPM) aims to overcome the traditional partisan bias
between mainstream medicine (conventional medicine) and
complementary medicine by way of continued dialogue at
eye level between acknowledged proponents of different
theoretical and practical approaches. Medical approaches
represented within the DPM are mainstream medicine,
anthroposophicic medicine, homeopathy, naturopathy and
Chinese Medicine (TCM). The DPM strives to separate the
wheat from the chaff and establish evidence-based
Integrative Medicine as a precondition for a fully
orchestrated healthcare system that meets the individually
varying needs and preferences of the population. Integrative
Medicine does not mean arbitrariness; we, too, believe a
distinction between dubious or even unreliable approaches
from serious and valuable ones to be essential [26, 28].
The DPM methodically explores different medical
approaches for their potential to complement each other, but
also for mutual exclusion. Pertinent targets are pursued at the
medical facilities listed below. A meticulous but unbiased
analysis of the published evidence on the efficacy of
homeopathy reveals that high-quality studies substantiate the
therapeutic efficacy of homeopathy, and that 90% of
available clinical studies would have to be ignored in order to
conclude that homeopathy has no effects [18]. Homeopathy
applied by physicians is an important element of an
Integrative Medicine which combines the best from
conventional medicine and medical homeopathy for the
benefit of patients.
After thorough evaluation Switzerland introduced
complementary medicine as a constitutional right. As a
consequence, homeopathy plus three other complementary
approaches are now covered by basic medical insurance in
Switzerland and must be taught at tertiary institutions for all
health professions. The decision was preceded by a national
referendum and a two-fold process of scientific evaluation.
Despite assertions to the contrary there are a considerable
number of high-quality homeopathy studies, although
homeopathy research does not receive institutional backing
[18, 23, 30].
Robert Hahn, professor of anaesthesiology and intensive
medicine at the Swedish University of Linköping, is the
author of more than 300 scientific papers in these two
medical disciplines. The winner of several research awards
who has never been involved with homeopathic issues before
has made the following comment [18]:
“The organization ‘Vetenskap och folkbildning’ (VoF)
(science and public education) launched a summer campaign
against homeopathy about three years ago. For the political
week in Almedalen the VoF equipped a group of teenagers
with t-shirts bearing the inscription ‘Jag är skeptisk’ (I am
sceptical). The group appeared on television together with
astronaut Christer Fuglesang, where they had the opportunity
to argue against homeopathy for an entire evening, with no-
one to contradict them. Presenting homeopathy as nothing
but a huge bluff, the teenagers all claimed there were no
scientific studies to demonstrate that homeopathy actually
works.
This disturbing event induced me to write something about
available evidence in favour of homeopathy. In the late
summer of 2011 my three blogs on the topic attracted
considerable attention. My aim was to explore those
scientific papers which addressed the question whether
homeopathy has a greater statistical effect on medical
disorders compared to a placebo (globules or dilutions). […]
In 2000 Ernst wrote a so-called meta-analysis on
homeopathy which actually was nothing but a systematic
overview. […] So who can be trusted? We may start by
weeding out Edzard Ernst. I have read some of the studies he
has published, and all of them are dubious.”
As to the Australian study quoted by Edzard Ernst as proof
of the inefficacy of homeopathy, it must be noted that this is
not a meta-analysis but a literature research which a priori
excluded homeopathy studies with less than 150 participants;
as a consequence, a considerable share of datasets were not
included in the evaluation [30, 31]. This means that the study
quoted by Ernst has no validity. Accordingly, the study was
not published in a peer reviewed journal.
 American Journal of Clinical and Experimental Medicine 2019; 7(2): 42-46
Accused of having falsified the review on homeopathy
[31], the National Health & Medical Research Council
(NHMRC) as the highest public health authority in Australia
had to admit to the Australian Senate that they manipulated
the report. Only five out of originally 176 studies made it to
the final round of high-quality studies. The decision not to
include other studies in the analysis was obviously based on
the fact that many of these studies showed positive findings
[31].
A position paper on medical professionalism and
complementary medicine published in Deutsches Ärzteblatt
in 2010 and signed by all DPM members underlined that
conventional and complementary medicine alike are obliged
to adhere to scientific standards [32].
Ernst is also inaccurate in equating placebo effect with
therapeutic ineffectiveness. Winfried Rief corrected this
claim in a commendable and highly competent reply which
appeared in Süddeutsche Zeitung (column “Außenansicht”)
on 22 August 2018. Rief refers to findings from modern
placebo research to point out that placebo interventions may
be highly effective and sustainable and that they depend on
patients’ and physicians’ positive (or negative) expectations,
so that not the pill in itself is important but what it stimulates
in the patient. Rief urgently recommends more intensive
research into placebo effects, also in view of their role in
mainstream medicine, and the integration of “placebo-related
interventions like homeopathy, acupuncture and some
naturopathic approaches” into medical and pharmaceutical
science.
For some decades the idea has been taking hold worldwide
that a fully orchestrated health system must be based on
Integrative Medicine in order to meet the manifold and
individually varying needs and preferences of the population,
and thereby the requirements of evidence-based medicine as
proclaimed by Sackett [33]. The concept of Integrative
Medicine describes a substantiated and transparent co-
existence of paradigms in the sense of different theoretical
and practical approaches.
The US-American Academic Consortium for Integrative
Medicine and Health with a membership of more than 60
leading medical schools defines Integrative Medicine as
follows: “Integrative medicine and health reaffirms the
importance of the relationship between practitioner and
patient, focuses on the whole person, is informed by
evidence, and makes use of all appropriate therapeutic and
lifestyle approaches, healthcare professionals and disciplines
to achieve optimal health and healing.” [34]. To those
involved, the concept of Integrative Medicine is a mission
statement which overcomes partiality between different
schools of thought in favour of integration, associated with
an objective search for therapy approaches best suited to the
individual patient. By the end of 2015, approximately
121,000 resident doctors in Germany distributed over ca.
95,000 surgeries applied complementary interventions. This
means that every second physician has already integrated
complementary medicine into daily medical practice.
Conclusion
44
All those who with eschatological doggedness demand the
exclusion of complementary therapies from reimbursement
via public health funds, and a ban on homeopathy and
withdrawal of homeopathic products, confirm what Thomas
Kuhn [35, 36] and Ludwig Fleck [37] described as the
dynamics of claiming privileges for one’s own paradigm via
legislation. But Germany is a secular country, and under
Basic Law (German constitution) Article 5 Paragraph 3, the
state is generally forbidden to pass judgment on scientific
matters in the sense of advocacy of one specific paradigm.
Maunz et al. address this aspect in detail in their commentary
to constitutional law: persons active in research and teaching
are authorized to reject any state intervention to influence the
process of gaining and conveying scientific findings – subject
to the obligation of loyalty according to Basic Law Article 5
Paragraph 3. Science, so Maunz et al., offers a sphere of
personal and autonomous responsibility for each researcher,
free from state control [38]. The state is forbidden by Basic
Law to give preferential treatment to individual scientific
approaches or medical paradigms. Accordingly, a
parliamentary committee charged with revising
pharmaceutical law in connection with the new Medical
Products Act passed in 1976 declared that “in a controversial
debate of scientific positions the legislator’s task cannot be to
unilaterally establish specific methods and thus determine a
generally binding ‘state of scientific knowledge’; instead, it
must be ensured that the scientific pluralism of drug therapies
is reflected in the approval of drugs or procedures” [39].
Homeopathic products are handled by a separate
committee at the Federal Institute for Drugs and Medical
Devices (AfArM), are described in the German
Pharmacopoeia of Homeopathy (HAB), and incorporated in
the German Social Security Code (SGB V).
When Hans-Georg Gadamer, doyen of hermeneutic
philosophy in Germany, was interviewed at the age of 100 by
the SPIEGEL magazine on 21 February 2000, and asked to
sum up the essence of his philosophy in one sentence, his
answer was: “The opponent might be right.”
You do not conduct a conversation if there is no chance
that your interlocutor is right. We in the Dialogue Forum
have modified the sentence as follows: “The opponent might
be right as well” [27].
Monoparadigmatic reductionism will always result in
totalitarian ideology, whether intended or not, with no respect
for citizens’ rights of self-determination, no tolerance
towards proponents of different theoretical and practical
approaches, no recognition of individual quest for
knowledge, nor respect for human dignity. Is that really what
we want for our system of medicine and healthcare:
totalitarian structures?
We as members of the Dialogue Forum Pluralism in
Medicine (DPM) and all other signatories will persist in our
efforts to maintain and develop scientific and ethical
pluralism in medicine as the fundament of a liberal and
democratic health system – a system that permits health care
in personal responsibility, consideration of the public interest
and critical benefit evaluation, with a focus on citizens’ and
45 Peter Friedemann Matthiessen: Homeopathy and Pluralism of Theories in Medicine Arguments Put Forward to Remove Homeopathic
Products from Pharmacies Contradict Actual Scientific Evidence and Suggest Deliberate Misinformation
patients’ individually varying needs and preferences.
Therefore we firmly reject any totalitarian thought patterns
and power claims like those behind the “Münsteraner
Memorandum Homöopathie” and the texts published by
Edzard Ernst and Werner Bartens in Süddeutsche Zeitung on
18 August 2018 and 11 October 2018 as irreconcilable with
constitutional law. Information to the general public on the
therapeutic efficacy of homeopathy should not be based on
pre-conceived and biased notions but on intellectual honesty.
Signatories
Dialogforum Pluralismus in der Medizin (DPM) –
Dialogue Forum Pluralism in Medicine
Hufelandgesellschaft e.V. Ärztlicher Dachverband für
Naturheilkunde und Integrative Medizin – Hufeland Society
– Physicians Umbrella Organization of Naturapathy,
Complementary and Integrative Medicine Association in
Germany
Wissenschaftliche Gesellschaft für Homöopathie
(WissHom) – Scientific Society for Homeopathy
Deutscher Zentralverein homöopathischer Ärzte (DZVhÄ)
– German Central Association of Homepathic Physicians
Gesellschaft anthroposophischer Ärzte in Deutschland e.V.
(GAÄD) – Physicians` Association for Anthroposophic
Medinice in Germany
Deutsche Ärztegesellschaft für Akupunktur (DÄGfA) –
German Medical Society for Acupuncture
Gesundheit Aktiv – Health Active – Citizen and Patient
Association
Privatärztlicher Bundesverband e.V. für Privatärzte in
Deutschland (PBV) - German Doctors Association of Private
Medicine
Address for Correspondence
Prof. Dr. med. Peter Friedemann Matthiessen
1st spokesman of the Dialogue Forum Pluralism in
Medicine (DPM)
Head of Division “Plurality in Medical Approaches”,
Institute of Integrative Medicine (IfIM) at Witten/Herdecke
University
Gerhard-Kienle-Weg 4
D-58313 Herdecke
Email: peter.matthiessen@uni-wh.de
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